In a recently released issue of Pediatrics(10.1542/peds.2020-1799), Dr. Erin Roby and colleagues describe a randomized controlled two-site clinical trial that tests a unique pediatric-practice based interactive video-taped intervention. This Video Interaction Project (VIP) is the universal primary prevention strategy component of a broader project called Smart Beginnings, designed to prevent school readiness disparities. This paper describes results of VIP, conducted through 6 months of age in pediatric practices in New York City and Pittsburgh PA. The targeted secondary/tertiary prevention strategy of Smart Beginnings called Family Check-up, which involves home visiting of at-risk families, is described for completeness but results are not included. Both the paper and the summary on ClinicalTrials.gov explain the larger project succinctly; again, here the authors focus on VIP.
If you remember the excellent teaching modules from Reach Out and Read, the child literacy project born in 1989 at Boston City Hospital (now Boston Medical Center), you will have a good feel for VIP. In those modules, pediatricians were filmed introducing a book to a child, while engaging the parent in the process. In VIP, at each pediatric visit in the well-care setting, a trained developmental specialist spends time with the parent discussing the child’s development, provides an age appropriate toy or book, and briefly video-records their interaction. The specialist then immediately reviews the video with the parent, noting positives and strengths in the interaction; the parent gets a copy of the video, a personalized pamphlet with developmental milestones and suggestions for age-appropriate play, and goals for interacting with their child at home. How great is that? Given the positive results the authors have identified in so many parent-child domains just at the 6 months point after 4 sessions (see the paper, especially under “Assessment of Cognitive Stimulation and Parent-Child Interaction”), I am eager for further results and also am dreaming of a way to make this happen at our practice.
The project’s over-arching goal is to promote parenting quality and school readiness. The intervention is intended for low-income families for whom disparities in school readiness are prevalent. Clearly figuring out an approach to VIP that is financially sustainable and logistically feasible in the practice setting will not be simple, but in my mind will be immensely worthwhile. Thanks to this group of researchers for thinking broadly and intervening thoughtfully with their research, which offers so many potential opportunities for pediatricians to make a difference.
